| NPI | 1700094364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IL 036122989) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101242708) |
| 207R00000X Internal Medicine (Licence: WA MD 60002695) | |
| 207R00000X Internal Medicine (Licence: OR MD28328) | |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2017-03-17 |